The Economic Driven by Politics as Values: The Example of Pharmaceuticals in France

ABSTRACT

Considering that the definitions of politics which dominate political economy are actually synonyms for other terms (politicians, powering or strategising), and in order to focus research more sharply upon the political itself, this article proposes a robust alternative: politics as the mobilisation of values to change or reproduce the institutions that orientate economic activity. Drawing upon constructivist strands of institutionalism, political sociology and industrial economics, this definition is used to build an analytical framework for understanding the ‘political work’ which determines the policies of both firms and public regulatory authorities. Specifically, using this ‘politics as values approach’, a fundamental tension within capitalism between the values of Freedom, Security and Equality is closely examined. This is tackled by studying conflicts within the definition of these three values during the regulation of specific industries, together with their prioritisation. To illustrate the heuristics of this analytical framework, the case of recent change within the regulation of medicines in France is then developed. Far from simply resulting from a drug ‘scandal’, this approach shows that this change was caused firstly by a value-driven conflict within pharmacology and, secondly, by its impacts upon the way administrators, journalists and politicians have reframed the Freedom–Security–Equality value hierarchy.

KEYWORDS:

• Politics
• industries
• values
• pharmaceuticals
• medicines
• regulation

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Andy Smith is a Research Professor in Politics based at the Centre Emile Durkheim, University of Bordeaux. His research interests include the political economy of industries, European integration and competition policies.

Notes

1 In a nutshell, whereas for Institutionalist Economists individuals and their rational-choice-driven interactions with other shape institutions (Oatley 2011, Tirole 2016), post-Marxists of varying hues point instead to power struggles between classes and social groups (Amable & Palombrini, 2008, Van Apeldoorn et al. 2009). Meanwhile, historical (Hall and Thelen 2008) and sociological institutionalists (Fligstein and McAdam 2012) propose intermediary positions which emphasise competition between actor coalitions.

2 Funded from 2009 to 2012 by France’s Agence Nationale de la Recherche and in 2015–16 by Bordeaux University’s IdeX programme, our research on the pharmaceutical industry has entailed more than 80 semi-structured industries in Bordeaux, Toulouse, Paris, Brussels, London and Prague, statistical analysis and business histories, scientometric analysis of publications, media analysis and case studies of several recent controversies.

3 I thank one of NPE’s astute referees for pointing out the linkages between this set of theory and my own approach.

4 The methodology set out below is, of course, largely shared by interpretativists (e.g. Huising and Silbey 2011, Carter 2013) or critical discourse theorists (e.g. Jorgensen and Mam Renofalt 2015, Eckersley 2016).

5 This renaming as the Agence française de sécurité sanitaire des produits de santé occurred in 1999.

6 This particular study is based firstly upon documentary evidence (including verbatim reports from market authorisation committees and parliamentary hearings, official reports), the specialised press – notably Préscrire – and generalist newspapers – essentially Le Monde, Le Figaro and Libération. Between June 2015 and June 2016, these data were used to structure a campaign of 25 semi-structured interviews, each of one to two hours, with senior actors who worked in the different professions and organisations cited throughout this piece. Throughout, Mattieu Ansaloni has carried out most of the empirical legwork and much of its analysis. I would also like to thank our colleagues in pharmacology (Bernard Bégaud, Antoine Pariente), law (Marine Aulois-Griot, Marie Baumevieille), economics (Matthieu Montalban) and political science (Cyril Benoît) for their input to this article and in helping us build its interdisciplinary home: the REWIND project (http://heads.u-bordeaux.fr/en/Research/DRUGS-REWIND-drugs-regulation/r674.html). I nevertheless take full responsibility for the interpretations presented here.

7 Judged purely by what the quantity of they publish, they are still more interested in exposing the ‘conflicts of interest’ which excite their respective editors.

8 The French Senate, ‘Rapport d’information fait au nom de la mission d’information commune “Mediator®: évaluation et contrôle des médicaments”’, Paris, 2011.

9 See here how the press agency Agence France-Presse recounted Bapt’s views, ‘Deux médicaments antidiabétiques, l’Actos® et le Competact®, pourraient voir leur vente suspendue’, 19 April 2011.

10 Anne Jouan, ‘Deux antidiabétiques créent une nouvelle polémique’, Le Figaro, 27 April 2011.

11 See, for example, Le Parisien, ‘Actos® et Competact®, les nouveaux Mediator®?’, Benoit Le Corre, 28 April 2011; L’Express, ‘Après le Mediator®, deux autres antidiabétiques suspectés’, Camille Caldini, 28 April 2011; Mediapart, ‘Gérard Bapt s’insurge contre Actos® et Compectact®: vers les nouveaux Mediator®?’, 28th April 2011; France 2, ‘Deux médicaments antidiabétiques, l’Actos® et Competact®, pourraient voir leur vente suspendue’, 28 April 2011.

Additional information

Funding

The research was funded by the French government’s Initiative d’excellence (IdEx) programme, and this via the University of Bordeaux’s project ‘Health Determinants and Societies’ (HEADS).